Discipline "General medical practice No. 1"
Practical exam (stage 1)
SITUATIONAL TASK №32
The patient is 35 years old, complains of cramping pains in the lower abdomen, moderate bloody discharge from the genital tract. Notes breast swelling, nausea, single vomiting in the morning for a month.
From anamnesis: Somatic diseases - biliary dyskinesia. This pregnancy is the 5th, childbirth – 1, spontaneous miscarriage - 3. Menstrual function - from the age of 14, after 28 days, 3-4 days, moderate, painless. Last menstruation 2 months ago.
On examination: The mucous membrane of the vagina and cervix are clean, pink in color. The discharge is bloody with clots. On bimanual examination: the cervix is shortened, the cervical canal is passable for 1 cm, the uterus is enlarged to 7-8 weeks of pregnancy, the tone of the uterus is increased. The appendages of the uterus are not palpable. Discharge from the genital tract is bloody with clots.
Test results:
Full CBC: Hb–100 г/л, RBC – 3.0х1012 г/л, WBC – 10.0х109 г/л, PLT – 200х109 г/л.
UA: LEU – 2-3 hpf, epithelial cells – 3-4 hpf, bacteria – abs, PRO – abs.
US: the uterine cavity is expanded to 20 mm, the fetal egg is not visualized.
Questions:
1. Preliminary diagnosis?
2. Examination plan?
3. Interpretation of test results.
4. Differential diagnosis and final diagnosis.
5. Treatment tactics
Discipline "General medical practice No. 1"
Practical exam (stage 1)
SITUATIONAL TASK №33
A 27-year-old pregnant woman with a gestation period of 30 weeks complains of abdominal pain, weakness, spotting from the genital tract for an hour.
From the anamnesis - this pregnancy is the 2nd. The 1st pregnancy took place against the background of severe preeclampsia. Menstrual function - from the age of 13, after 30 days, 3-4 days, moderate, painless.
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